New Heart Procedure Performed through the Wrist
By Will C. Hurley, MD FACC, Board Certified Cardiologist at Yankton Medical Clinic, P.C.
As a general rule, people undergoing heart catheterizations in the United States do so with the procedure starting at the femoral artery found in the groin. However, the next time a Yankton Medical Clinic, P.C. patient has a cardiac catheterization, he or she may be surprised to find that the pathway to the heart starts at the wrist (transradial access) and not the groin (transfemoral access). Yankton Medical Clinic, P.C. Cardiologists, Will C. Hurley, MD, FACC and Timothy Irwin, MD, have embraced the transradial approach as a way to reduce the risk of complications, improve patient outcomes and to significantly improve the overall patient experience. Drs. Hurley and Irwin perform their catheterizations at Avera Sacred Heart Hospital.
The transradial approach uses the wrist to gain access to arteries that lead to the patient’s heart. Once access to the artery is made, the cardiologist is able to perform either a diagnostic procedure, which determines if and where there are blockages that impede the flow of blood to the heart muscle, or an interventional procedure (angioplasty) to open up the blocked artery.
“Cardiologists have been expanding the use of transradial access for both diagnostic and interventional procedures to ensure better patient outcomes and comfort,” said Dr. Hurley. “As a general rule, patients and referring physicians have preferred this procedure as it enables the patients to be mobile much faster and with less post-procedure pain.”
Each year, more than a million cardiac catheterizations are performed in the United States, with most starting with a puncture to the femoral artery in the groin. While this is the most common approach, the entry point is sometimes difficult to access and has a greater associated risk of bleeding complications, especially in women. It can be associated with post-procedure pain and slower recovery period. Post procedure, patients receiving transfemoral access are generally required to lie still for four to six hours while pressure is applied to the access area to ensure hemostasis (no further bleeding) before the patient can get up and walk around.
For certain types of patients, including obese patients, women, the elderly, and patients with peripheral vascular disease, transradial access provides documented reductions in bleeding complications including hematomas (swelling), less back pain and quicker recovery. In fact, patients treated with transradial access are able to sit up and walk around almost immediately after the procedure. As a result, these patients are more likely to be discharged faster than those treated with transfemoral access.
In this past year, there has been a growing interest among medical professionals in the United States to learn the transradial technique as a way to reduce bleeding complications, procedure costs, shorten hospital stays and improve satisfaction. Please talk to your doctor if you have further questions about this procedure.